<div class="modal-dialog ">
    <div class="modal-content" id="modal-content-tpls">
        <div class="modal-header">
            <button type="button" class="close" data-dismiss="modal" aria-hidden="true">×</button>
            <div class="modal-title" id="myModalLabel">
                复核
            </div>
        </div>
        <form id="validForm" name="validForm" method="post" class="form-horizontal layer_msg">
            <div class="modal-body">
                <div class="form-group">
                    <label class="col-sm-3 control-label">商户编号</label>
                    <div class="col-sm-8">
                        <input type="text" class="form-control" id="merchno" name="merchno"  readonly/>
                    </div>
                </div>
                <div class="form-group">
                    <label class="col-sm-3 control-label">商户名称</label>
                    <div class="col-sm-8">
                        <input type="text" class="form-control" id="MerchantName"  name="MerchantName" readonly/>
                    </div>
                </div>
                <!--<div class="form-group">
                    <label class="col-sm-3 control-label">地区</label>
                    <div class="col-sm-8">
                        <input type="text" class="form-control" id="Name" name="Name" readonly/>
                    </div>
                </div>-->
                <div class="form-group">
                    <label class="col-sm-3 control-label">当前商户跨行设置</label>
                    <div class="col-sm-8">
                        <input type="text" class="form-control" id="feeflag" name="feeflag" readonly/>
                    </div>
                </div>
                <div class="form-group">
                    <label class="col-sm-3 control-label">目标商户跨行设置</label>
                    <div class="col-sm-8">
                        <input type="text" class="form-control" id="verifyfeeflag" name="verifyfeeflag" readonly/>
                    </div>
                </div>
                <div class="form-group">
                    <label class="col-sm-3 control-label">MCC</label>
                    <div class="col-sm-4">
                        <input type="text" class="form-control" id="typename" name="typename" readonly/>
                    </div>
                    <div class="col-sm-4">
                        <input type="text" class="form-control" id="mccname" name="mccname" readonly/>
                    </div>
                </div>
                <div class="form-group">
                    <label class="col-sm-3 control-label">当前特殊计费</label>
                    <div class="col-sm-8">
                        <input type="text" class="form-control" id="feetype" name="feetype" readonly/>
                    </div>
                </div>
                <div class="form-group">
                    <label class="col-sm-3 control-label">目标特殊计费</label>
                    <div class="col-sm-8">
                        <input type="text" class="form-control" id="verifyfeetype" name="verifyfeetype" readonly/>
                    </div>
                </div>
                <!--<div class="form-group">
                    <label class="col-sm-3 control-label">复核结果</label>
                    <div class="col-sm-8">
                        <select class="form-control" id="ConfirmNoteSel" name="ConfirmNoteSel" required>
                            <option value="">请选择</option>
                            <option value="01">复核通过</option>
                            <option value="99">复核不通过</option>
                        </select>
                    </div>
                </div>-->
                <input type="hidden"  id="ConfirmNoteSel" name="ConfirmNoteSel" value="01">
            </div>
            <div class="modal-footer">
                <button id="modal-btn-save" type="submit" class="btn btn-primary">复核</button>
                <button id="modal-btn-close" type="button" class="btn btn-default" data-dismiss="modal">关闭</button>
            </div>
        </form>
    </div>
</div>